Performance Improvement 1999. State Children's Health Insurance Program


TITLE: Sampling the States: Local Reflections on State Implementation of State Children's Health Insurance

ABSTRACT: The State Children's Health Insurance Program (SCHIP) was signed into law as Title XXI of the Social Security Act as part of the Balanced Budget Act of 1997. Title XXI provides $24 billion for child health over five years and $50 billion over 10 years in block grants to the States. This study was funded to obtain a grassroots perspective from local advocates, providers, and public health leaders on the impact SCHIP may have on children's health. A formative discussion, using qualitative research methods, was conducted with almost 40 individuals in 10 States which represent more than half of all uninsured children in the Nation. Perspectives were obtained on: (1) State plans for outreach and enrollment; (2) benefits package and design; (3) target populations; (4) the role of local coalitions and the respondent's role; (5) emerging service delivery system issues; (6) the role of safety net providers and linkages among providers; (7) quality of care/quality standards; and (8) thoughts on the program's promise, local concerns and vision. The study found that major system capacity issues, especially for dental and mental health care, were not being addressed aggressively by the States. Care for rural and migrant populations, enrollment of immigrant populations, services for adolescents, and benefit coverage and system redesigns to serve children with special needs or who are chronically ill also will require more attention. In addition, the study found that innovation in the enhancement of service delivery may require greater technical and financial support from the Federal Government, such as through issuance of Federal guidelines that offer increased flexibility and waiver options.

AGENCY SPONSOR: Office of the Administrator

FEDERAL CONTACT: Karen Thiel Raykovich, Ph.D.

PHONE NUMBER: 301-443-3070

PIC ID: 7068

PERFORMER ORGANIZATION: Coalition for Healthier Cities and Communities, Health Research and Educational Trust, Chicago, IL